Venous Access Device

CONTENTS:

Types of Long-term Venous Access Devices

Risks or Complications

Placing the Venous Access Device

What to Expect after Surgery

Care of your Venous Access Device

Your doctor has requested that you have a long-term Venous Access Device inserted to administer medications, nutrition or blood.

The insertion of the Venous Access Device involves the placement of a plastic intravenous tube (catheter) through your skin and into a vein. Please read this form so that we can be sure you understand the risks and complications potentially associated with this procedure.

Please question your surgeon or nurse about anything that you do not understand.

Two types of long-term intravenous Venous Access Devices

External catheter (Broviac or Hickman catheter)

This is a soft, flexible tube that is tunneled under the skin of the chest and inserted into a large vein near the heart. These catheters have a single or double tube or "lumen". Tunneled catheters can eliminate the need for needle sticks and assure ready access to the blood stream. They require daily care; some home nursing support and restrict bathing and swimming.

Totally implanted catheter (portacath or mediport)

A portacath or "port" is comprised of two components, a self-sealing injection port and a catheter that enters the vein. The port and catheter are placed entirely under the skin using a small incision. There will be bump on the chest wall where the injection port is located. This is the site where the access needle is placed. Ports assure ready access to the blood stream with no daily home care or restricted bathing or swimming. They require monthly access and flushing to prevent plugging, if not in use for other purposes.

Risks or Complications

The insertion and use of long term Venous Access Devices is very safe. However, you need to understand the risks and complications.

The potential complications that may occur during insertion of the Venous Access Device include but are not limited to the following:

Puncture or collapse of a lung (pneumothorax)

Injury to a vein or artery in the chest or neck

Injury to nerves to the chest or neck

Bleeding into the neck (hematoma) or chest (hemothorax)

Irregular heartbeat (arrhythmias)

Puncture of the heart leading to bleeding (cardiac tamponade)

Introduction of excessive air into the blood stream (air embolism)

Long term risks of the Venous Access Device include but are not limited to the following:

Infection of the catheter leading to a blood borne infection (bacteremia or septic shock)

Blood clots of the veins in the arm, chest or neck (thombosis or thrombophlebitis)

Catheter malfunction including rupture and leakage of blood or drugs

Catheter disconnection or migration of the catheter into the heart

Erosion of port or catheter through skin and/or blood vessel

Rejection of the device by the body

Placing the Venous Access Device

The surgeon will place your Venous Access Device while you are in the operating room. To assist with location of the catheter, X-ray contrast medium may be injected into the catheter and X-ray pictures taken to confirm that the catheter is correctly positioned.

An IV will be started in your arm or hand for medicine to help you to relax (sedation). You will be given an antibiotic through your IV during the procedure to reduce the risk of infection The surgeon will use a local anesthetic to numb the chest, neck and shoulder. Although you may be aware of the activity around you and feel some pressure on your chest, you should not feel any pain. You may even fall asleep during the procedure.

The surgeon will make two small incisions.

The first incision is made at the collarbone or the neck. It is used to place the catheter into the vein in the chest or neck.

The second incision is made on your lower chest. The catheter is placed under the skin from the first incision to the second.

Both incisions will be held together by stitches or a special tape.

What to expect after surgery

After surgery, you should expect some bruising, swelling and tenderness on the side of your body where the Venous Access Device is placed. These changes will go away after 24 – 48 hours. If needed, you may take pain medicine. Your incisions will heal in about 7 – 10 days.

Call you doctor or nurse at the numbers you entered on this page, below, if you have any of the following:

Increased bruising, swelling, tenderness

More pain or redness at your incision sites

Fever or chills

Shortness of breath

Dizziness

Increased bleeding or drainage from your incisions

Any problems with your Venous Access Device

Care of your Venous Access Device

Specially trained nurses will be able to help you with instructions to care for your Venous Access Device. Your nurse or doctor will answer questions you may have about resuming activities.